Independent association between sarcopenic obesity and knee osteoarthritis: A cross-sectional study

Although obesity is a known risk factor for knee osteoarthritis (OA), the impact of sarcopenic obesity (SO) on OA remains unclear. This study aimed to investigate the association between SO and knee OA in older adults. This cross-sectional study included 101 obese outpatients, of whom 61 (60.3%) had knee OA. SO was diagnosed using ESPEN/EASO criteria. OA presence was determined by two specialists based on bilateral standing knee radiographs and Kellgren-Lawrence (KL) grading (0-4). Joint cartilage was assessed via ultrasonography. Frailty was evaluated using the Clinical Frailty Scale. Osteoporosis (OP) was defined by bone mineral density measurements and confirmed fragility fractures. The study participants comprised 74 (73%) females and 27 (27%) males with a median age of 72.0 [8.0] years. The patients were divided into two groups: patients with OA (60.3%, n = 61) and those without OA (39.7%, n = 40). In regression analysis, the presence of SO increased the risk of OA independent of age, sex, body mass index (BMI), frailty, and OP (OR = 5.82, 95% CI = 1.55-21.94 and p = 0.009). The study results highlight the independent role of SO in OA development, suggesting that body composition assessment should be integrated into OA risk evaluation.